Individual
LAUREN FREDRICKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1995 E STATE ST, SALEM, OH 44460-2423
(330) 332-1551
Mailing address
1995 E STATE ST, SALEM, OH 44460-2423
Taxonomy
Speciality
Code
Description
License number
State
146D00000X
Personal Emergency Response Attendant
Primary
35062338
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
942460636205
CARESOURCE
OH
01
—
P00194286
MEDICARE RR-GA
OH
Enumeration date
06/08/2006
Last updated
04/05/2014
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